The present invention relates to an apparatus and method for anastomosis.
In surgical techniques, the term anastomosis means the connection of organs or histological elements.
In particular, where said connection is between two portions of a blood vessel, a lymph vessel or other type of duct, specific reference is made to end anastomosis, referring to an end-to-end connection between the two portions, in order to restore the original continuity of the above-mentioned vessel or duct.
In the description which follows, specific reference is made to end-to-end vascular anastomosis applied to the human body, although without limiting the scope of application of the invention.
A known technique for anastomosis of two portions of a blood or lymph vessel consists in suturing the free flaps of the portions.
A similar technique, commonly known as suture anastomosis, has various disadvantages.
A first disadvantage is the fact that, since the suture creates more or less marked scarring of the vessel upon which the surgery is performed, it does not perfectly restore the original continuity of the vessel.
On this subject, it must be emphasised that, as is known, blood vessels have a multi-layer structure, in which a first inner layer, called the endothelium of the tunica intima, is covered by a second, middle layer, called the tunica intima. The tunica intima is, in turn covered, by means of an elastic membrane, by a third middle layer, called the tunica media.
The tunica media is covered, by means of an elastic membrane, by a fourth middle layer, called the tunica adventitia, which is in turn coated, by means of a fifth layer of feeding vessels, by a sixth, external layer called the wall nerve.
It is, therefore, evident that suturing the flaps normally results in a more or less accentuated misalignment of the above-mentioned layers of one flap and the corresponding layers of the other flap. This disadvantage also arises in the case of lymph vessels, which also have a multi-layer structure.
A second disadvantage is the fact that the flaps must be sutured manually by a surgeon, since this complex operation cannot be entrusted to a robot.
Another known technique for anastomosis of two portions of a blood or lymph vessel consists of using special mechanical locking devices designed to fix the above-mentioned flaps together.
A similar type of anastomosis, commonly known as mechanical anastomosis, normally involves everting the flaps of the portions to be joined, bringing together the inner layers of the everted flaps and fixing the flaps together by means of the above-mentioned mechanical locking devices, which operate upon the outer layers of the flaps.
Mechanical anastomosis performed as described above, normally known as mechanical anastomosis by eversion, is more simple than suture anastomosis, but, in contrast to the latter, does not restore the original continuity of the vessel at all.
For example, in the specific case of blood vessels, it is evident that the layers over the endothelium of the tunica intima of one flap remain isolated from the corresponding layers over the endothelium of the tunica intima of the other flap.
Moreover, mechanical anastomosis by eversion has further serious disadvantages which mean that it endangers the health of the patient.
A first disadvantage is the fact that the operation in which the flaps are everted may result in rupture of the flaps themselves, particularly in the case of vessels with a large diameter, such as arteries.
Another disadvantage, specific to blood vessels, is the fact that the inner layers of the flaps which are everted and which have been brought together are no longer supplied with blood and tend to atrophy, resulting in serious complaints for the patient. This disadvantage in particular is more acutely felt as the diameter of the vessel operated upon gets smaller.
The aim of the present invention is to provide an apparatus for anastomosis which is free of the disadvantages indicated with reference to the background art.
Accordingly, the present invention provides an apparatus for anastomosis between a first and a second part of a vessel or duct, said first and second parts respectively having a first and a second end portion delimited by free end edges. The apparatus is characterised in that it comprises first connecting means which are shaped and may be positioned on the first end portion in order to engage the first end portion with the exception of the free end edge, second connecting means which are shaped and may be positioned on the second end portion in order to engage the second end portion with the exception of the free end edge, and connecting means for connecting and fixing together the first and second connecting means in a position in which they are attached to one another and in which the end edges meet in a configuration of close and total reciprocal contact.
Another aim of the present invention is to provide a method for anastomosis which is free of the disadvantages mentioned with reference to the background art.
Accordingly, the present invention provides a method for anastomosis between a first and a second part of a vessel or duct, said first and second parts respectively having a first and a second end portion delimited by free end edges. The method is characterised in that it comprises a step of connecting the first and second connecting means to the first and second end portions. Said connecting means are shaped and may be positioned on the first and, respectively, the second end portion in order to engage the first and, respectively, second end portion with the exception of the free end edge; and connecting and fixing together the first and second connecting means in a position in which they are attached to one another and in which the end edges meet in a configuration of close and total reciprocal contact.